Impact of Secondary ADHD on Long-Term Outcomes After Early Childhood Traumatic Brain Injury.
Megan E Narad, Jacqlyn Riemersma, Shari L Wade and 5 others
PMID 31834065WHAT IT FOUND
Children who developed new attention problems years after a brain injury showed significantly worse behavior control and daily functioning in early adolescence.
This risk was much higher than in children with orthopedic injuries who developed similar attention issues.
Key findings
01New-onset attention problems after brain injury were associated with significantly worse global executive functioning and behavioral regulation compared to children without these problems.
02Children with both brain injury and new-onset attention problems had significantly higher scores for functional impairment than those with orthopedic injury and similar attention problems.
03New-onset attention problems occurred in nearly half of the brain injury group compared to only 13.6% of the orthopedic injury group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on parent report to define ADHD and assess outcomes, which may introduce bias or miss subtle symptoms. There is potential overlap between the items used to define ADHD (CBCL) and those used to measure executive function (BRIEF), which could inflate the association between the two. The orthopedic injury group was not a healthy control group and may have had higher baseline risks for attention problems. Some children labeled with secondary ADHD might have had undiagnosed primary ADHD due to their young age at injury. Psychiatric comorbidities other than ADHD were not assessed, so their contribution to functional impairment is unknown.
Declared interests
The authors disclosed no conflicts of interest. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not assume that all attention problems after brain injury are identical to developmental ADHD. The study found that behavioral regulation and daily functioning were significantly worse in the TBI group compared to the orthopedic injury group with similar attention issues, suggesting the injury itself may amplify the impact of these symptoms.